Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 868 | CA |
NPI | 1013037043 |
---|---|
Provider Name | Ms. Judy Goucher |
First Address | Trinidad, CA 95570-0863 |
Second Address | Arcata, CA 95521-4742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2007 |
Last Update Date | 20/09/2019 |